Despite improvements in hand hygiene, stricter compliance requirements, and efforts to optimize isolation practices, hospitals and other healthcare facilities are losing the war on nosocomial or Hospital Acquired Infections (HAIs). A hospital acquired infection is an infection acquired in a hospital or other healthcare facility by a patient admitted for some reason other than that specific infection. Hospital acquired infections may include infections appearing 48 hours or more after hospital admission or within 30 days after discharge. They may also include infections due to transmission from colonized healthcare workers, or occupational exposure to infection among staff of the facility. Although the majority of hospital acquired infections are preventable, sadly their incidence has only increased.
Hospital acquired infections have become more rampant as antibiotic resistance spreads. Many factors contribute to the increased incidence of hospital acquired infections among hospital patients. For example, hospitals house large numbers of people who are sick and therefore have weakened immune systems. Medical staff move from patient to patient and see many patients a day, providing a way for pathogens to spread. Research indicates that hand hygiene practices are followed only 40% of the time by healthcare workers, even after exhaustive process improvements and training efforts. Many medical procedures, such as surgery, injections, and other invasive procedures bypass the body's natural protective barriers, providing entry points for pathogens. The wide-spread use of antibiotics has contributed to the emergence of resistant strains of microorganisms in healthcare facilities and well as in the community.
Nearly ¾ of surfaces in patient rooms are contaminated even after housekeeping has been completed. Many high touch objects in the patient room, such as doorknobs, bedrails, telephone, etc. are continuously re-contaminated. Patients and healthcare workers are thus exposed to many sources for potential pathogen transmission within a hospital room.
In addition, between 70% and 90% of incoming patients carrying Methicillin-Resistant Staphylococcus aureus (MRSA) or Vanocomycin-Resistant Enterococci (VRE) are never identified and isolated. Many hospitals are unaware that MRSA lingers on patient room surfaces long after the colonized patient is discharged. Doctors and nurses carry MRSA on their lab coats and uniforms 65% of the time, potentially passing this organism to other patients or the environment.
It has been estimated that 1 out of every 20 patients contract hospital acquired infections. This translates to nearly 2,000,000 patients each year. By 1995, deaths from documented hospital acquired infections had escalated to almost 90,000 per year for an average of 345 per hospital. The costs associated with hospital acquired infections are significant. The cost to treat hospital acquired infections has been estimated to reach $30 to $50 billion per year. The average additional hospital costs for a patient contracting a hospital acquired infection is $15,275.
Although certain individuals, such as the critically ill, the elderly, young children and those with compromised immune systems are at greater risk, no patient is immune from the risk of acquiring an infection during a doctor visit or hospital stay.